Antidepressant counselling Flashcards

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1
Q

focussed depression hx

A

low mood, energy, enjoyment

poor sleep, appetite, concentration

RISK

explore previous tx & establish current understanding

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2
Q

ATHLETICS of antidepressants

A

tablet

PO morning after breakfast

SSRIs increase serotonin (happy hormone) in brain

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3
Q

stepwise approach to antidepressant therapy according to efficacy

A

SSRIs work within 6m in 60& of people (if 1st episode) - most within 3-4w

if no response –> different SSRI –> 80%

if no response –> venlafaxine (SNRI) or mitrazapine (NaSSA) or amitriptyline (MOA)

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4
Q

duration of antidepressant

A

after feeling better

if 1st episode –> continue for 6 months

if 2nd episode –> 1-2 years

> =3 episodes –> 3-5 years

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5
Q

SSRIs cessation

A

gradual

not addictive

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6
Q

SEs

A

GI upset, insomnia, low libido, self-harm thoughts, seretonin syndrome (agitation, sweating, palpitations, fever)

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7
Q

SSRI monitoring

A

2w follow up appt (1w if <25)

if high dose citalopram ECG for ++QT

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8
Q

pregnancy advice

A

generally avoid

consider if benefits > risks

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9
Q

brief biopsychosocial

A

bio - meds

psycho - IAPT, CBT

social - alcohol, exercise, job

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10
Q

serotonin syndrome warning

A

find out things that increase serotonin when co-prescribed along SSRIs

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